Usman Mirza, MD, MBA

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

306390 Issued in NY

Practice address

815 Hallock Ave Ste a
Port Jefferson Station, NY 11776-1244

Phone

(631) 828-3036

NPI assigned

Jul 12, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Neurology

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Peconic Bay Medical Center Hospital, Riverhead, NY, CCN 330107
• John T Mather Memorial Hospital of Port Jefferson Hospital, Port Jefferson, NY, CCN 330185
• Suny/Stony Brook University Hospital Hospital, Stony Brook, NY, CCN 330393
• NS/Lij HS Southside Hospital Hospital, Bay Shore, NY, CCN 330043

Merit-based Incentive Payment System (MIPS)

Final score

93.07 of 100Reported as apm

Quality

79.77

Promoting interoperability

88.77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Business Administration, Doctor of Medicine

Practice roles

Locations

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722

Interoperability endpoints

• Direct secure messaging: umirza29109@northwell.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• North Shore-Lij Medical PC

  • Urology Physician
  • Great Neck, NY
  • NPI 1053688572
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Central Suffolk Hospital

  • General Acute Care Hospital
  • Riverhead, NY
  • NPI 1386649804
  Care Compare affiliation
• John T. Mather Memorial Hospital

  • General Acute Care Hospital
  • Port Jefferson, NY
  • NPI 1093718728
  Care Compare affiliation
• South Shore University Hospital

  • General Acute Care Hospital
  • Bay Shore, NY
  • NPI 1457369381
  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1033224704
  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Southampton, NY
  • NPI 1225507114
  Care Compare affiliation
• University Hospital at Stony Brook

  • Land Ambulance
  • Stony Brook, NY
  • NPI 1306620588

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Greenport, NY
  • NPI 1881690691
  Care Compare affiliation
• University Hospital at Stony Brook

  • Clinic/Center
  • Greenport, NY
  • NPI 1932466604

  Hospital

  Care Compare affiliation
• University Hospital at Stony Brook

  • General Acute Care Hospital
  • Stony Brook, NY
  • NPI 1972523348
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1499817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714089600000",
    "number": "1912429895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 HALLOCK AVE STE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761244",
            "telephone_number": "631-828-3036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 HALLOCK AVE STE A",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117761244",
            "telephone_number": "631-828-3036"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1300 Roanoke Ave",
            "address_purpose": "LOCATION",
            "city": "Riverhead",
            "state": "NY",
            "postal_code": "119012031",
            "country_code": "US",
            "telephone_number": "631-548-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Community Dr Dept Of",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303876",
            "country_code": "US",
            "telephone_number": "516-562-4300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "USMAN",
        "name_prefix": "Dr.",
        "credential": "MD, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-12",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084E0001X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Epilepsy",
            "state": "NY",
            "license": "306390",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NY",
            "license": "306390",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Megan Miller, LMHC
• Zara Clare Miller, OT
• Amy Elizabeth Millheiser, LCSW
• Melena Leigh Mills, RPH
• Mary Anne Miranda, NP-C
• Haim Misholy, M.D.
• Lorene Margaret Mistretta, R.N.
• Eric Ira Mitchnick, MD
• Jacquelyn Mitra
• Antoun Saba Mitromaras, M.D.

• Neurology Physician in Port Jefferson Station, NY
• Providers in Port Jefferson Station, NY by specialty
• Neurology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.